Eosinophilic pleural effusion with eosinophilia of peripheral blood
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Pneumon 2003;16(2):215-220
A 41 year-old man was admitted to our Hospital because of pleuritic chest pain and mild fever (37,4°C). He had no medical history. He had been treated with roxythromycin for the preceding ten days. Routine physical examination revealed dullness and decreased breath sounds over the basal part of the right hemithorax. His labaratory data revealed leukocytosis with hypereosinophilia. At initial thoracentesis, an exudative effusion containing 54% eosinophils was documented with simultaneous peripheral eosinophilia of 35%. Values for the remainder of his labaratory studies were within normal range. There were no nuclear antibodies and no rheumatic factor; screening for parasites, bacteria, mycobacteria and malignant cells was negative. Tuberculin skin reaction was positive (19mm). Chest radiography showed moderate accumulation of fluid in the right pleural space. Computed tomographic films of the thorax showed pleural effusion in both lungs with no hilar or mediastinal lymph node enlargement. The patient underwent video-assisted-thoracic surgery (VATS) procedure to establish a diagnosis. Histologically there were lesions that formed granulomas. Antituberculous therapy was adninistered and six months later a new X-ray was normal. Conclusion: Pleural fluid eosinophilia does not exclude the diagnosis of tuberculous pleuritis. Pneumon 2003, 16(2):215-220.
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